A comparison between arthrocentesis and arthroscopic approaches.
Temporomandibular Syndrome is a somewhat general descriptive term
comprising several distinct pathologies, all related to the various structures of the temporomandibular joint. TMJ symptomatology ranges from general myofascial discomfort, which can often be addressed by conservative (non-invasive) approaches, to profoundly pathological interarticular mechanical malfunctions requiring extensive surgical repairs. The paper shows that the relatively recent development of minimally invasive techniques, such as arthrocentesis and arthroscopy, offer the maxillofacial specialist surgical approaches to address many TMJ problems that do not resolve with conservative (non-surgical) treatments, but which are not appropriately addressed by arthrotomy. The paper shows that even minimally invasive techniques present the risk of potential complications unique to each procedure, so a comprehensive risk/benefit analysis and careful evaluation is also essential as between arthrocentesis and arthroscopy on a case-by-case basis.
comprising several distinct pathologies, all related to the various structures of the temporomandibular joint. TMJ symptomatology ranges from general myofascial discomfort, which can often be addressed by conservative (non-invasive) approaches, to profoundly pathological interarticular mechanical malfunctions requiring extensive surgical repairs. The paper shows that the relatively recent development of minimally invasive techniques, such as arthrocentesis and arthroscopy, offer the maxillofacial specialist surgical approaches to address many TMJ problems that do not resolve with conservative (non-surgical) treatments, but which are not appropriately addressed by arthrotomy. The paper shows that even minimally invasive techniques present the risk of potential complications unique to each procedure, so a comprehensive risk/benefit analysis and careful evaluation is also essential as between arthrocentesis and arthroscopy on a case-by-case basis.
“Like other (even minimally) invasive surgical procedures, arthroscopy carries with it certain risks and potential complications such as post-operative infection, which is always a possibility anytime a 2.0mm or 3.0mm instrument is introduced interarticularly. Despite its proven diagnostic value and multitude of uses, it allows only a very narrow
view and requires considerable care and practiced skill on the part of the surgeon to avoid disrupting delicate structures and blood vessels. In particular with respect to temporomandibular repairs, these risks include disruption of the superficial temporal artery, intracapsular bleeding, neurological injury such as a middle cranial fossa perforation, in addition to otologic complications including ear drum perforation.(9)”
view and requires considerable care and practiced skill on the part of the surgeon to avoid disrupting delicate structures and blood vessels. In particular with respect to temporomandibular repairs, these risks include disruption of the superficial temporal artery, intracapsular bleeding, neurological injury such as a middle cranial fossa perforation, in addition to otologic complications including ear drum perforation.(9)”